An important part of the Patient Protection and Affordable Care Act (“PPACA”) is its expansion of Medicaid, but the PPACA will also impact Medicare. As discussed on Monday, Medicare is the program for which SSDI beneficiaries qualify after two years of benefits.
Affordable Care Act and Medicare
The reforms that the PPACA enacts in regards to Medicare should be beneficial for disability beneficiaries receiving health care through Medicare. Here are several of the key changes:
- The premiums that beneficiaries pay for Medicare Part B coverage should be lower in the coming years thanks to the PPACA
- The PPACA closes the so-called “donut hole” of Medicare prescription drug coverage so that people with high prescriptive drug costs will receive discounts on the drugs they need; by 2020, the donut hole is not expected to exist at all
- The new law implements a number of cost-cutting measures that will trim excess payments to hospitals and doctors, improve fraud investigations and oversight, and focus on preventive care, which keeps people healthy before they develop expensive, life-threatening medical issues
Affordable Care Act and Medicaid
There is some interplay between Medicaid and disability benefits. In most states, SSI benefits and Medicaid use the same application, but, in others, including Oklahoma, the Medicaid process is different. Often you may be eligible for Medicaid even if Social Security does not grant you disability benefits.
The PPACA should help many disability applicants in that it expands Medicaid’s possible coverage to people with incomes at or below 133 percent of the federal poverty line, which should open the doors for more Americans with lower incomes to obtain health coverage. While some governors and state officials have already balked at accepting the expansion, many experts think that this is political rhetoric and that most or all states will ultimately accept the expansion, especially since the federal government covers 100 percent of the costs in the first few years of expansion and then never less than 90 percent.
Have health problems presented financial difficulties for you and your family? Contact our Tulsa SSI experts to learn more about what determines eligibility for SSI or SSDI benefits.